Deaths in road accidents have continued to climb, new police data show, spiked largely by speeding, drink-driving, non-use of helmets, overloading, poor visibility, and lack of training.
Grace Kizza, 28, is one of the hundreds of boda boda crash victims that the national referral hospital, Mulago, receives for treatment every month.
Kizza, an online clothes seller, almost lost her right leg when she was knocked off a boda boda by a car, at Upper Kololo Terrace junction traffic lights, in Kampala. She was knocked on October 17, at 7 pm, while rushing home to beat the 7 pm curfew.
“When the traffic lights allowed the boda boda motorcyclist to cross the junction, the speeding car from another side also moved and knocked the motorcycle carrying Kizza. Kizza and the boda cyclist were badly injured. Kizza’s leg broke and her bone was exposed,” Ibra Baguma, Kizza’s brother, said in an interview.
“Rescuers at the scene stole Kizza’s bag, which had Shs1.8m. They also stole her mobile phone set worth Shs 800,000 and later carried the victims into a police patrol car that took them to Naguru hospital for first-aid,” he said.
“We paid Shs 200,000 for Kizza’s admission and the boda cyclist at Naguru hospital. We also paid Shs 580,000 for Kizza’s first-aid treatment, before being transferred to Mulago hospital for an orthopedic specialist to operate on her leg. The cyclist was discharged with minor injuries,” Richard, the driver of the car which knocked Kizza, said.
Makerere School of Public Health
Esther Bayiga, a research associate in the department of Disease Control and Environmental Health at Makerere University, School of Public Health (SPH), said road crashes in Uganda and Africa kill more people than Covid-19 and Malaria.
“According to the police Annual Crime and Road Safety Report 2020, a total of 3,663 people were killed in road crashes in just one year and 8,370 people were injured. However, in two years since Covid-19 broke out in 2020, about 3,200 people have died,” she said.
According to the police report, there were over 3, 269 crashes in 2020, a drop of 4.1 percent; from the 3,407 accidents in 2019. The report says most people killed in road crashes were pedestrians accounting for 34 percent, motorcyclists, 31 percent; and passengers, 25 percent.
Interviewed for this story, the Commissioner in charge of Traffic, Lawrence Nuwabiine, said boda boda cyclists lack skills in traffic regulation because they don’t have leadership and professional training centers.
A UN report found that Uganda loses about 10 people per day in road crashes mainly due to speeding, which is the highest in East Africa. Richard, driver of the accident car, said he paid Shs 1.2m on Kizza’s leg operation and medication at Mulago hospital. She was later referred to Kiruddu hospital for plastic surgery and grafting.
“At Kiruddu, we paid Shs 2.5m for a plastic surgeon and medication. Since Kizza got the crash, we have spent over Shs 5m on her treatment. The costs are increasing daily since we don’t know how long it will take her to recover. Exposed bones are very expensive to treat,” Baguma said.
Another boda victim, Matayo Kikumbe, 30, was transferred to Mulago hospital from Hoima hospital to get his broken bones fixed by a specialist.
“He knocked a stationary car by the roadside while speeding on his bike. He broke his leg, thigh, arm and ribs. We are looking for Shs 2m, which doctors need, to fix Matayo’s bones,” Matayo’s mother, Night Peshalina, 68, said.
Rick Matovu, 7, was knocked by a hit-and-run boda boda motorcyclist at Kiteezi, Kawempe division, as he was crossing the road to buy tomatoes.
“Matovu’s thigh was broken and doctors want Shs 150,000 to fix it. I am stuck, my husband refused to give me money, saying I am careless with children,” Sarah Namugerwa, Matovu’s mother, said.
Fred Mugenyi, 35, a boda boda rider at Namasuba stage, in Kampala, was knocked by a car at Seguku, Entebbe road on October 17, at 7 pm.
“Doctors said he hurt his spinal cord and broke his legs. His lower body is paralyzed yet we have spent over Shs 1.2m on different scans, medication, and other tests including Covid-19 and the heart. We are looking for Shs 600,000 for a spinal cord operation,” Mugenyi’s wife, Immaculate Nabisere, said.
Mulago accident ward
Dr Alexander Bangirana, the head of Accident Emergencies at Mulago hospital, said doctors are only allowed to ask for money to buy expensive medicines, metals, and sundries to fix broken bones since government hospitals don’t provide such items.
“We provide free human resource services like doctors and nurses because they are paid by the government. If any doctor asks for money for human service, report him. In government hospitals, you don’t pay for specialists and other facilities like theatre, admissions, and dressings,” he said, adding that most people can’t afford to buy expensive implants like metals and sundries such as bandages and plasters to fix bones.
Bangirana said a leg implant costs between Shs 600,000 and Shs 2m depending on the type of injury and implant.
“The more broken parts in your body, the more costly it is to fix them.”
“Special sundries to fix a head injury cost about Shs 1m. The hospital gives about one month for a badly injured patient to stabilize in the Neurosurgical or Orthopedic ward. However, many patients are discharged when they are still depressed and traumatized. Others end up mentally sick or feel victimized especially when they lose arms or legs,” Bangirana said, adding that between September 2020 and September 2021, Mulago hospital received 5,619 road crash victims of whom 3,331 were motorists, while 2,288 were boda boda cyclists or passengers.
Bangirana said the casualty ward still grapples with a daily high turnout of accident victims, which piles pressure on human resources and the few medical supplies.
“You can’t give expected and timely services when patients are overcrowded at the ward, yet doctors are not enough,” he said.
Cost of motorcycle accident
An updated 2015 study on the cost of motorcycle accidents in Uganda found that motorcycle accidents are tied to the huge economic and non-economic burden of pain and grief by the crash victims and society.
The study, done by Richard Sebaggala, Fred Matovu and Dan Ayebale, and other researchers from Makerere University and Uganda Christian University, found that “It costs about Shs 7m, ($ 2,800) to treat a boda boda accident victim who is badly injured.”
It also found that the Ugandan economy loses more than Shs 3bn ($1.2m) in terms of lost output due to days spent away from productive work as a result of severe injuries and death.
“If a youth dies in a crash at 35 years and yet life expectancy in Uganda is 67 years, the nation loses 32 productive years of that person, to produce children, pay taxes, build houses and make other developments,” Irene Namuyiga, the Road Safety Engineer and Transport Planner at KCCA, said.
Road crash loss
Uganda loses about Shs 5 trillion ($ 1.2bn) due to road crashes annually, according to the Uganda Bureau of Statistics (UBOS), Statistical Abstract 2017/18). The loss represents five percent of Uganda’s Gross Domestic Product (GDP).
Road safety compliance
Another 2019 study on road safety compliance among motorcyclists in Uganda found that majority of East African countries; Uganda, Tanzania and Rwanda, have the highest number of motorcycle patients in the casualty wards.
The study, done by Margaret Ndagire, Suzanne Kiwanuka, Nino Paichadze, and Olive Kobusingye from Makerere University School of Public Health, found that more than three-quarters of road crashes affect males mostly in their youth years (15-49 years) yet they are the majority breadwinners and busiest on the road.
“Majority of road crashes between 70 and 90 percent are due to human error, like speeding, drink-driving, non-use of helmets, overloading, poor visibility and lack of training…,” the study says.
The study also suggests some remedial measures to reduce road crashes such as improving road designs, use of helmets, wearing reflective jackets, adequate training before riding motorcycles, valid riding permits and maintaining motorcycles in good mechanical condition, avoid speeding and riding when drunk.
“Use of helmets by cyclists reduces the risk of road traffic fatality by more than 25 percent and the risk of head injury by 70 percent or any brain damage during a crash,” the study found.
However, Bayiga said their latest study on helmet use in Uganda found that some boda cyclists fear wearing helmets. They claim they are expensive and are of poor quality. They break during a crash, and the broken pieces injure their skull.
Dr Olive Kobusingye, director of the Trauma, Injuries and Disability program at Makerere University, School of Public Health, said their latest research on boda cyclists proposes a plan for all road users to have selected spaces on the road to avoid crashes.
Namuyiga, however, said managing road safety space and usage is not about increasing or widening lanes; it’s about improving public transport and use of mass transit movement of people.
“When you move in large numbers at once, like a bus carrying 70 people, it reduces chances of crashes than having many vehicles and motorcycles on the road, carrying two or three people, which also increases traffic jam,” she said.
Global Plan Action 2021–2030
According to the Global Plan Action for Road Safety 2021-2030, WHO and UN target to reduce road traffic deaths and injuries by 50 percent within that decade by calling on governments and stakeholders to implement an integrated safe system approach, which positions road safety as a key driver of sustainable development.
The report also says that globally, road traffic crashes cause nearly 1.3 million preventable deaths and 50 million injuries annually, making it the leading killer of children and young people worldwide.
“They are set to cause a further estimated 13 million deaths and 500 million injuries during the next decade and hinder sustainable development, particularly in low and middle-income countries,” according to the report.
Namuyiga says road safety is allocated about one percent of the national budget because decision-makers, politicians, and other stakeholders don’t know much about the implication of losing youths, having many orphans, and school dropouts, which strain the country’s development.
“The money, which government spends on orphans and crippled parents in hospitals, would have been invested in other developments like buying drugs, building schools and houses for people,” Namuyiga said.